4668 Ridge Cliffe Dr - BL88917
For Office Use I
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City of Ea <
Permit Fee:
APR 2
3830 Pilot Knob Road
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 I
Fax: (651) 675-5694 1 Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: (3 T9 Q U C l Phone: LS I I L_ .-7 V U
Address / City / Zip: lp L 8 f (I q t t t
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 3 wtiid aw 1' tp [o lym/ A-7s fn I ?(J 7~f)7 o,2r/)/f
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Construction Cost: 3 aOt l.~ Multi-Family Building: (Yes No
THD At-Home Services, Inc.
CONTRACTOR Name 2690 Cumberland Pkwy, Ste 300 License
Addre Cumberland Office Park ( l 3 y S- t b Y 7
Atlanta, GA 30339-3913
City: - Lic# 20268257 Ph. 763/ 542-8826 - State: Zip:
Phone: Contact Person: ~ Elder JbntS
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
plicant's Printed Name (Applicant's Signature
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